Mindfulness

The Use of Labels: Alcoholic and Addict

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment

Labels can have powerful effects on our conscious and subconscious beliefs about ourselves and the future actions we engage in. This can be seen well in the world of sports when we think about transcendent athletes such as Michael Jackson, or Tiger Woods. Their belief and self-talk that they are the best to do it was a major factor in the various moments they found themselves in when being neck and neck with an opponent. Labels can often have a self-fulling nature, and can work for us, or against us.

I am often asked about the use of common labels in recovery such as alcoholic and drug addict. It is my belief that anyone can use whichever labels they find helpful for themselves, while I do not personally use either of those labels when referring to myself (as someone who had an opiate addiction) or others. In the 12-Step approach, identifying as an alcoholic or addict is actively encouraged with the intent of pushing people through their denial of the problem and as an indelible reminder of where their addiction took them. This identification can be helpful for some, and for others it can feel disheartening and triggering.

Chemical addiction is a spectrum disorder, with distinctions between mild, moderate and severe. There are associations of the stereotypical “addict/alcoholic” living on the streets, with no family, job, resources or self-care that come to mind for many of my clients which discourage the use of these labels on themselves. All one needs to do is attend a 12-Step meeting and they will be given plenty of examples of others similar to themselves, yet there is still an adverse response when using this label on themselves or when loved ones use it on them or encourage them to accept that is what they are. The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (APA, 2013), is the clinical book used by mental health professionals to diagnose mental health disorders. Addict and alcoholic are not words used to describe substance disorders, instead, they are called alcohol use disorder, opiate use disorder, stimulant use disorder etc.

While someone may have a dependence on alcohol, they are not an alcoholic. They are struggling with an alcohol use disorder, and if they are no longer meeting that criteria after a full year, then they are in sustained remission (APA, 2013). Labels are powerful, and when taking a self-empowering approach, which I am a proponent of, it can be helpful to ditch the use of labels and instead acknowledge that there has been a dependency on a substance and lifestyle that is no longer working. When asked if I am an addict, I tell people that in the past I struggled with problematic substance use, and today I do not. I encourage clients to use whatever verbiage works for them, as I have worked with many clients in a 12-step program who chose to identify with the words addict/alcoholic. If you find power in those labels, who am I to tell you to not use them! On the other hand, if you feel repulsed or put off by them, know that you do not have to use them, and there is plenty of evidence that their use can be detrimental to progress for many. Afterall, what does an addict/alcoholic do? They drink and use, relapse, hurt those around them, fail to live up to their commitments, and struggle to succeed in life. Those labels can often run through one’s mind right before a relapse, with the mind saying, “well you are an alcoholic so you might as well take that drink, after all, that is what you do.”

Working in a self-empowering program, people are taught to focus on their strengths and the goals in which they want to achieve. Instead of focusing on not drinking today, we strive to focus on the things we want to achieve for the day and aligning our behaviors with our identified values. These are skills and philosophies that we teach at Realize Recovery, both to individuals and to loved ones who may only know the mainstream 12-step alcohol/addict philosophy. Please keep in mind, this is not a demonizing of the 12-step program, as it worked and continues to work for many people, it is simply an alternative perspective to be used in conjunction with the 12-steps, or as an alternative.

How the Abstinence Violation Effect Affects Recovery

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment

Have you ever made a determination to start a new habit and have you been able to stay 100% dedicated to it through the remainder of your life? (insert cricket sound…) Of course, if you are reading this then you are still living and cannot confirm nor deny the attainment of this goal. If you are like most people, you set a goal to establish some new behavior which can be performed consistently and probably have sometimes where you fall short of your idealized expectations. Perhaps you said you would start waking up an hour earlier so you can exercise, or you’ve sworn off some specific type of food, only to find yourself having periodic success.

This is all a normal part of the change process. Setting a goal, taking steps to achieve it, and at times falling short. For those struggling with some form of addiction, this is a very relatable topic. Making a commitment to stop drinking only to find yourself days, weeks, months or years down the road ingesting alcohol. If you can relate with this, I’d like you to think of a time when you deviated from your goal to abstain and what your mind told you the moment you veered off that path. Did it say something to the effect of “Well, you’ve had one so you might as well drink the rest of the 6 pack…” or “I knew I couldn’t do this, afterall I am an alcoholic and I always screw things up and get drunk”, or even “I slipped yesterday so I am only at day one so I might as well keep going and I can start again tomorrow”. This type of thinking is a prime example of the Abstinence Violation Effect, or AVE.

The Abstinence Violation Effect is when there is any deviation from a desired behavior goal and this deviation is viewed as a total failure. This viewpoint that the deviation is a total failure is then used as a further justification to continue using or doing the addictive behavior. I have had clients that expressed after having one sip of a drink, they felt so badly and shameful for failing that this was the permission giving thought that getting drunk wouldn’t be any worse. After 5 years of sobriety, someone had a glass of champagne at a wedding and then felt that they had wasted their 5 years of sobriety and would have to start over anyway, so they ended up going on a binge for the next 18 months for fear of having to “start over”.

While this phenomenon is common with all types of people, it is often seen the most in those who put a strong emphasis on total consecutive days sober, as opposed to cumulative days sober. If you’ve struggled with an addiction, imagine the most acute period when you were struggling, and then imagine if someone told you that you would have 5 years sober, with only a glass of champagne, or one use of your addiction over the course of those 5 years.  Would you see that as a victory, or would you focus on the fact that you had one day out of 1,825 days where you engaged in your addiction and therefore failed?

It is suggested to work on staying in the moment and not beating yourself up for deviating from the path of your desired goal. Just like your phone navigation system will autocorrect when you drive off the assigned path, so too can you make a course correction if you fall back into an old behavior pattern, however short or long in duration. One sip is better than one beer, one beer is better than dusting off the whole 12 pack and so on. We need not use one slip to justify continued slips. An old quote I enjoy: Start where you are, use what you have, and do what you can!

Practicing Mindfulness

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment

If you or someone you know is struggling with problematic drinking or using behaviors, chances are you feel a great deal of stress, anxiety, fear, and depressive thoughts surrounding this behavior. Managing thoughts about cravings, regrets of the past, and fears of the future can feel so overwhelming that engaging in mind-altering chemicals seems like a rational idea. Practicing mindfulness helps avoid the fears of the future and the resentments and regrets of the past by bringing one’s attention to the present moment and a more solutions-focused attitude.  

As I discussed in the previous post about how beneficial mindfulness can be, it begs the question of how does one practice mindfulness when the mind is constantly jumping from one thought to the other? Simple answer: with patience and persistent practice. When we begin to notice our habitual mode of thinking it can be easy to get discouraged because our habitual thinking may be very pessimistic and negative.  That is a good sign you are on the track to changing!  Through mindful awareness of our thoughts we give ourselves the opportunity to choose a different, more helpful thought process. 

Integrating mindfulness into your daily life may not be as hard as it first appears because we are already practicing some mindfulness each day.  Anytime your mind is fully in the present moment and not focused on the past or future, you are practicing mindfulness.  Setting an intention to practice mindfulness can be a helpful first step to push you to make an action plan on how you can be proactive in establishing your new cognitive habit.  Here are some easy and quick ways you begin using mindfulness in your daily life.  

-Showering:  This is an excellent time to put your attention on all the bodily sensations that are felt from washing your hair, scrubbing your body and feeling the relaxing water flow over your skin.  When a thought comes to the mind, calmly and patiently bring your attention back to the flow of the water coursing over your skin.

-Driving: While driving alone focus on the surrounding sights and be fully present absorbing all the visual scenes and sounds around you.  The goal is to observe objectively, without labeling and judging what is happening on the roads.  Simply observe and notice without engaging in judgmental thoughts.  

Eating:  With each bite put your full attention on the taste, texture, temperature, and smell.  You can use this technique with a meal or a dessert item you can really savor slowly.  

Sitting still:  Sit upright in a chair with eyes closed and simply put your attention on your breath.  Watch each inhalation and exhalation with deepest attention.  Challenge yourself to be mindful for three consecutive breaths.  If, and when, a thought comes into your mind, acknowledge the attention has wandered, then calmly and patiently bring it back to the awareness of your breath.  Practice for 3-5 minutes 2-3 times a day.  

Practicing mindfulness changes the structure of our brain, and over time will change the way we think.  Having more conscious control over our thinking and not being dragged aimlessly from thought to thought, we are better able to engage in daily activities with calmness and poise.  You can learn how to consciously choose which thoughts to entertain and which thoughts to simply observe, and then let go.  

Mindfulness – Where is your mind?

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment
Mindfulness: By thinking differently, we develop new neural connections and diminishing the use of old connections, changing the landscape of our brain.

Many of us have heard of the term mindfulness and may feel like we have a general understanding of what mindfulness is about.   Common answers I hear when asking clients what mindfulness means to them are being aware, present, not focusing on negativity, and being in the here and now.  What commonly follows their definition is that mindfulness is very difficult to do regularly, doesn’t help them much, or it is a struggle to practice with so many distractions vying for their attention.  Being someone who has been practicing mindfulness daily for over a decade, I can agree that it is a challenge and a battle.  Just like any other learned behavior or habit change, it takes patience, consistency and determination to establish the habit of mindfulness on a regular basis. 

Why is mindfulness helpful?  Numerous studies strongly suggest that by practicing mindfulness one can lower anxiety and depression, cope with life stressors more effectively, improve life satisfaction and increase one’s sense of self-esteem and many other synergistic health benefits.  While all that sounds good, from a practical standpoint I find mindfulness helps me enjoy each day more fully, the time spent with others and activities I engage in.  The older we get the faster time seems to move. By practicing mindfulness, I find I can retain more information and fully experience each moment.  My attention isn’t concerned about the past (which is associated with regret or depression) or worried about the future (associated with anxiety and fear).  

Mindfulness can be so impactful because it is literally regrooving our brains.  By the simple act of thinking differently, we are developing new neural connections and diminishing the use of old connections, thus changing the landscape of our brain.  This is a subtle change and something that does not happen overnight.  An analogy: look at a picture of yourself 10 years ago, do your notice that you have changed physically?  Most of us would notice specific changes in our appearance when referencing a photo but we did not notice these changes happening daily, in the moment.  The same thing occurs with cognitive changes because they are so subtle, but when we look back a year or more we may notice we are completely different people.   

I’ve trained myself to get in the habit of thinking, where is my mind?  By being in the present moment, focused on the task or activity at hand fully and completely, I can plan for the future, handle stress, interact with others authentically, and live a life with no regrets because I am here now, experiencing the moment and nothing else.  This mindset helps me reflect on the past and what I have learned as well as plan for the future consciously and objectively, if those are things I need to think about.  I am no longer at the mercy of my intrusive thoughts aimlessly dragging me through the mud of regret, resentment, sadness, anxiety and fear.   

Next post we will jump into techniques and strategies for integrating mindfulness into our daily life and how to overcome common roadblocks which continue to pull us into fear, anxiety and depression.